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MSS PCM Exam 2 > Final Exam Shit! > Flashcards

Final Exam Shit! Flashcards

1
Q

OPIM

A

other potentially infectious materials

-treat all human blood and OPIM as if known to be infectious with bloodborne disease

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2
Q

when do needlesticks occur?

A

40% during use
40% after use
15% during disposal
5% recapping

break in skin from needle or other sharp**

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3
Q

2 common problems in patients when doing needlestick?

A

fainting

allergic reaction

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4
Q

major contraindications for injection?

A

hypersensitivity
inflamed/irritated skin
pregnant/breastfeeding
stopper latex - patient allergic

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5
Q

intradermal injection?

A

10-15 degrees
small syringe and small gauge needle
-creates a wheal**

for diagnostic and local anesthetics

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6
Q

subQ injection?

A

45-90 (45 degrees preferred)
slow-sustained absorption
abdomen, upper arm, anterior thigh, glutes

variety of needle and syringe sizes

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7
Q

intramuscular injection

A

90 degree angle
rapid, systemic action of lage dose of medication
vaccine injection

syringe and needle size vary greatly

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8
Q

injection site for IM injection?

A 
deltoid
gluteus medius
vastus lateralis
rectus femoris
gluteus maximus
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9
Q

size of needle?

A

anesthesia 30 gauge
injection 22-25 gauge
aspiration 18-20 gauge

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10
Q

lidocaine versus bupivicaine?

A

lidocaine is short duration

bupivicaine is log duration (nerve block)

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11
Q

epinephrine?

A

can be mixed with lido or bupiv for vasoconstriction

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12
Q

post injection care?

A

dressing 8-12 hours
ice (15 minutes 1-2x per hour)
NSAIDs first 24-48 hours

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13
Q

shoulder injection?

A

glenohumeral

acromioclavicular

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14
Q

hand injection?

A

carpal tunnel
first carpometacarpal joint
trigger finger
de Quervains tenosynovitis

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15
Q

finkelstein test

A

dequervains tenosynovitis

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16
Q

elbow injection?

A

olecranon bursitis
epicondylitis

humerus, radius, ulna triangle

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17
Q

trigger point injections?

A

3x
local anesthetic
advance until reach tenderpoint

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18
Q

basis of most radiologic dyes?

A

iodine (shellfish allergy as well)

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19
Q

fixed drug reaction?

A

allergic reaction that happens with drug

always occurs in the same location

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20
Q

mcmurrays test

A

meniscus

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21
Q

drawer sign

A

ACL PCL

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22
Q

medial and lateral instability

A

medial/lateral collateral

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23
Q

sarcoma

A

cancer of connective tissue

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24
Q

ratio of BUN/Creatinine?

A

should be 10-20

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25
Q

liver function tests

A

bilirubin
albumin
prothrombin time

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26
Q

alkaline phosphatase level?

A

elevated for lots of problems

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27
Q

alkaline phosphatase

A 
liver
bone
intestine
placenta
tumor

gotta fractionate it**

  • will tell where it comes from
  • majority bone and liver
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28
Q

sedimentation rate

A

indicates inflammatory process
-never diagnostic**

autoimmune
infection
neoplasm

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29
Q

osteosarcoma

A

malignant mesenchymal tumor

most common malignant tumor of bone
20% of all bone cancers
often in younger patients

association with retinoblastoma

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30
Q

anterior neck triangle?

A

superior - mandible
medial - midline of neck
lateral - sternocleidomastoid

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31
Q

posterior neck triangle?

A

inferior - clavicle
posterior - trapezius
anterior - sternocleidomastoid

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32
Q

throat cartilage?

A

thyroid - on top

cricoid - below thyroid

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33
Q

cervical lymph drainage

A

most to deep system

  • deep to sternocleidomastoid
  • not palpable
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34
Q

virchows node

A

supraclavicular of deep chain

sometimes palpable

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35
Q

thyroglossal duct cyst

A

of thyroglossal duct does not close before birth

-may form cyst

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36
Q

spurlings maneuver?

A

cervical compression test

  • sidebending and compression to affected side
  • radicular symptoms
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37
Q

maximum cervical compression test?

A

extension and rotation to same side as head is bent in spurlings

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38
Q

distraction test?

A

elevate head

-alleviate radicular symptoms

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39
Q

thoracic outlet syndrome

A

compression of vessels and nerves around clavicle

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40
Q

roos test

A

arms out abducted to 90 and flexed elbows

patient opens closes hands for 3 minutes

numbness or weakness - thoracic outlet syndrome

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41
Q

adsons test

A

palpate radial pulse with elbow and shoulder in extension

move arm into abduction and external rotation and have patient turn head AWAY from tested side

pulse diminished - thoracic outlet syndrome

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42
Q

rotator cuff muscles?

A

supraspinatus
infraspinatus
teres minor
subscapularis

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43
Q

apley scratch test

A

scratch back with both arms

upper - external rotation and abduction
lower - internal rotation and adduction

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44
Q

strength test scale?

A

0 no active movement
1 muscle contraction, no movement
2 full active ROM with no gravity
3 full active ROM against gravity
4 full active ROM against partial resistance
5 full active ROM against full resistance

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45
Q

supraspinatus test?

A

abducts against resistance

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46
Q

subscapularis test?

A

internal rotation against resistance

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47
Q

infraspinatus/teres minor test?

A

external rotation against resistance

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48
Q

thoracohumeral group test?

A

adducts forearm against resistance

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49
Q

empty can test?

A

indicates injury to supraspinatus

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50
Q

lift off test

A

subscapularis injury

patient hand behind back
-lifts hand off back

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51
Q

crossover test

A

compresses AC joint

adduct arm across chest

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52
Q

drop arm test

A

patient slowly abducts arm from 90 degrees

indicates rotator cuff problem

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53
Q

apprehension test

A

arm abducted and externally rotated
-pressure gently forward

pain indicates loose joint capsule

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54
Q

obriens test

A

flex arm and adduct across chest
internally rotate with thumb pointing down and push down on arm

pain positive for labral tear
SLAP - superior labrum anterior to posterior

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55
Q

speeds test

A

test biceps tendon

patient resists flexion of arm

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56
Q

hawkins impingement sign

A

grasp patients elbow and distal forearm

passive external rotation - subscapularis

passive internal rotation - supraspinatus, teres minor, infraspinatus

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57
Q

nursemaids elbow

A

radial head dislocation

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58
Q

cubital tunnel syndrome

A

ulnar nerve compression behind medial epicondyle

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59
Q

tennis elbow

A

lateral epicondylitis

extensor tendonitis

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60
Q

golfers elbow

A

medial epicondylitis

flexor tendonitis

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61
Q

varus test

A

lateral ligaments of elbow

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62
Q

valgus test

A

medial ligaments of elbow

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63
Q

heberdens node

A

distal interphalangeal

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64
Q

bouchards nodes

A

proximal interphalangeal

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65
Q

boutonnieres deformity

A

rheumatoid arthritis

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66
Q

tinels sign

A

tap over median nerve

carpal tunnel syndrome
-not specific, good for any compression neuropathy

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67
Q

phalens maneuver

A

flex wrists against one another

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68
Q

colles fracture?

A

distal radius fracture with fragment displaced dorsally

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69
Q

boxers fracture

A

distal 5th metacarpal

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70
Q

scaphoid fracture

A

snuffbox tenderness

poor blood supply**

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71
Q

dupuytrens contracture

A

4th and 5th digit palmar fascia thickening

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72
Q

trigger finger

A

inflammation of flexor digitorum tendon sheath

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73
Q

grind test

A

carpo-metacarpal osteoarthritis

rotate metacarpal and rotate back and forth

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74
Q

finkelsteins test

A

hold thumb - ulnar deviate wrist

positive - dequerveins disease

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75
Q

popliteal artery

A

posterior to knee

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76
Q

posterior tibial artery

A

posterior to medial malleolus

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77
Q

pulse ratings?

A

0 can’t palpate
1 diminished
2 normal briskness (expected)
3 bounding

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78
Q

auscultation of artery?

A

with bell

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79
Q

ankle brachial index

A

less than 0.9 = abnormal
-peripheral arterial disease

comparison of systolic pressures of each

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80
Q

allen test

A

patient opens and closes hand and fist several times

pressure over radial and ulnar arteries

release - should return color to hand (pink)

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81
Q

postural color change test

A

chronic PAD

elevated extremity for 1 minute
-if becomes pale, lower to observe return of color

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82
Q

acute arterial occlusion

A

embolus - often thromboembolus

sudden extreme pain

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83
Q

PAD

A

chronic inadequate aterial flow

muscle fatigue, weakness, cold feet

ankle-brachial index less than 0.9

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84
Q

venous valve competency test

A

patient supine, raise one leg to 90 degrees
-occlude great saphenous vein and lower leg

watch for slow filling with pressure

  • release pressure
  • if rapid distension, indicates rapid filling and incompetent valves
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85
Q

homans sign

A

flex knee and dorsiflex foot

-pain indicates thromboemboli

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86
Q

saphenous vein

A

great - medial

small - posterior

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87
Q

virchows triad

A

stasis
hypercoagubility
endothelial injury

results in DVT

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88
Q

thrombophlebitis

A

DVT in smaller leg vein

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89
Q

varicose vein

A

incompetent veins

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90
Q

mapping varicose veins

A

finger on vein

-tap, should feel pressure wave

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91
Q

chronic venous insufficiency

A

because of damaged valves

92
Q

lymphedema?

A

non-pitting**

93
Q

malignant lymphadenopathy

A 
greater than 1cm
non tender
rock hard
fixed
difficult to palpate
94
Q

lymphangitis?

A

infection of lymphatics

95
Q

pitting vs. non-pitting edema

A

pitting - fluid overload/cardiac problem

non-pitting - lymph problem

96
Q

grading edema?

A

1 - 2mm pit resolves quickly
2 - 4mm pit resolves less than 1 minute
3 - 6mm pit lasts 1-2 minutes
4 - 8mm pit 2-5 minutes

97
Q

erythema nodosum

A

inflammation of skin of shins
gradual onset**

immune reaction/ systemic infection

98
Q

cellulitis

A

inflammation of skin / subQ tissue

almost always bacterial infection
acute onset**

99
Q

paroxysmal

A

episodic

100
Q

claudication

A

pain in skeletal muscle

101
Q

angina

A

pain in heart (cardiac myo)

102
Q

heave

A

heart enlarged

103
Q

thrill

A

murmur

104
Q

mitral regurgitation

A

systolic murmur

105
Q

mitral stenosis

A

diastolic murmur

106
Q

holosystolic murmur?

A

through entire systole

107
Q

mitral valve prolapse?

A

only portion of systolic murmur

108
Q

MCV

A

cell size - higher is macrocytic

anemia

109
Q

MCH

A

cell concentration

110
Q

macrocytic anemia

A

secondary to alcoholism

111
Q

beta hydroxybutyrate

A

ketone measure

112
Q

diabetic ketoacidosis

A

high glucose
high ketone
acidic pH

113
Q

DKA compensation?

A

respiratory - blow off CO2

114
Q

anion gap

A

measures where acidosis comes from

DKA is increased gap

115
Q

pre-renal?

A

greater than 20 BUN/Cr ration

116
Q

where sodium goes?

A

water goes

117
Q

liver function?

A

PT
bilirubin
albumin

118
Q

liver inflammation

A

ALT

AST

119
Q

hypothyroid

A

high TSH

low T4

120
Q

BNP

A

b-type natriuretic peptide
-hormone secreted by myocytes due to pressure and stretch

LV dysfunction sensitive marker
-not Dx specific

121
Q

cardiomegaly

A

greater than 2:1 ratio heart:lung size

122
Q

types of cardiomyopathy?

A

dilated (alcoholics)

hypertrophic

123
Q

heart failure

A

decreased contractility
(starling curve analysis)
-lower slope

124
Q

embolic stroke

A

embolus from atrium goes to brain

125
Q

calcium channel blocker

A

decreased contractility

126
Q

patient centered interviewing

A

from patients perspective

127
Q

pitfalls of patient centered interview?

A

time constraint

low access to bio information

128
Q

nondirective dimension (patient centered)

A

1-2 minutes at beginning

asks how are things - 30 second pause

129
Q

directive dimension (patient centered)

A

increased participation by physician
as little as 3-4 minutes

directing conversation to primary concern of patient

130
Q

directive dimension

A

develop personal story

131
Q

transition phase

A

patient had opportunity to share

patient IS AWARE that physician understands

132
Q

physician-centered interviewing

A

open end medical questions

directive and nondirective

133
Q

AV valves

A

tricuspid and mitral

134
Q

semilunar valves

A

aortic and pulmonic

135
Q

S1

A

closure of mitral and tricuspid

louder at apex

136
Q

S2

A

aortic and pulmonic

louder at base

can be heard splitting

137
Q

S2 splitting?

A

A2 before P2

138
Q

S3

A

ventricular gallop

139
Q

S4

A

atrial gallop

140
Q

grading murmurs

A

1 very faint
2 quiet, immediately heard with stethoscope on chest
3 moderately
4 loud with palpable thrill
5 very loud with thrill may be heard with stethoscope partially off chest
6 very loud with thrill, heary with stethoscope entirely off chest

141
Q

position to feel PMI?

A

left lateral decubitus

142
Q

JVP

A

jugular venous pressure
-for right heart pressures

greater than 9cm above RA is abnormal

143
Q

A wave

A

RA contraction

144
Q

X descent

A

RA relaxation

145
Q

V wave

A

RA filling

146
Q

Y descent

A

RA emptying

147
Q

hepatojugular reflex

A

should see distension 2-3 seconds

extended time is abnormal

148
Q

diaphragm

A

high pitched S1 and S2

149
Q

bell

A

low pitched S3 and S4

150
Q

innocent murmur

A

venous hum

stills (musical)

151
Q

border of lung

A

MCL - 6th rib
midaxillary - 8th rib
posterior - 10th rib

152
Q

horizontal fissure

A

in right lung only

153
Q

fremitus

A

vibrations through to chest wall when patient speaks (normal)

154
Q

dull sound

A

liver

155
Q

resnonant sound

A

lung

156
Q

flat sound

A

thigh

157
Q

tympanic sound

A

gastric bubble or puffed cheeks

158
Q

diaphragmatic excursion

A

normal 5-6cm

159
Q

vesicular breath sounds

A

inspiration

low pitch

160
Q

bronchovesicular breath sounds

A

inspiration and expiration

intermediate pitch

161
Q

bronchial breath sounds

A

expiration

high pitched

162
Q

tracheal breath sounds

A

inspiration and expiration

high pitched

163
Q

sibilant rhonchi

A

wheeze

high pitched

164
Q

sonorous rhonchi

A

rhonchi

low pitched

165
Q

stridor

A

almost entirely inspiration

louder in neck than chest wall

166
Q

crackles/rales

A

discontinuous

intermittent and nonmusical

167
Q

bronchophony

A

say 99

168
Q

egophony

A

say ee

169
Q

whispered pectoriloquy

A

whisper 99

170
Q

stance

A

60% walk cycle

171
Q

swing

A

40% walk cycle

172
Q

L4

A

iliac crest

173
Q

reinforcement

A

engaging bilateral muscle groups in a region above spinal level of reflex being tested

174
Q

L4 dermatome

A

lateral ankle to large toe

175
Q

L5 dermatome

A

mid top of foot and plantar foot

176
Q

S1 dermatome

A

lateral foot

177
Q

T12-L2

A

colon and rectum
bladder
uterus
prostate

178
Q

T10-T11

A

small intestine

ovaries/testies

179
Q

most common injury lumbar spine

A

L5-S1

180
Q

reiters syndrome

A

uveitis
sacroilitis
urethritis

181
Q

sciatic nerve

A

L4-S3

182
Q

straight leg raise

A

sciatica

183
Q

order of things under inguinal ligament?

A 
NAVEL
nerve
artery
vein
empty
lymph node
184
Q

trendelenburg test?

A

gluteus medius

-keeps hip stable during gait

185
Q

ober test

A

IT band

abduct leg and let it down

186
Q

thomas test

A

psoas flexion contractures

flex at hip and knee (like a high knee)

187
Q

fabere test?

A

aka patric test
hip joint
make a 4 with your legs and push down on knee

188
Q

leg length

A

ASIS to medial malleolus

189
Q

psoas test

A

seated, raise knee, resist down pressure

190
Q

piriformis test

A

palpation

191
Q

bulge sign

A

minor effusion

192
Q

balloon sign

A

large effusion

193
Q

balloting

A

large effusion

194
Q

housemaids knee

A

prepatellar bursitis - anterior

195
Q

anserine bursitis

A

medial

196
Q

bakers cyst

A

posterior

197
Q

apprehension test

A

patella

198
Q

anterior drawer test

A

ACL

199
Q

lachman test

A

only ACL

200
Q

posterior drawer test

A

PCL

201
Q

mcmurray test

A

meniscus

patient supine

202
Q

apley compression test

A

meniscus

patient prone

203
Q

thessaly test

A

dancing meniscus

204
Q

thompson test

A

squeeze calf - plantar flex foot

positive - achilles rupture

205
Q

talar tilt test

A

calcaneofibular ligaments

ATF torn

206
Q

ottowa rule

A

inability to bear wight after 4 steps or tenderness over posterior aspect of either malleolus

FRACTURE

207
Q

kleiger test

A

high ankle sprain

208
Q

anterior drawer test

A

anterior talofibular ligament

209
Q

pes planus

A

flat foot

210
Q

hallux valgus

A

abduction of great toe (bunion)

211
Q

tinnitus

A

ringing ears

212
Q

epistaxis

A

nose bleed

213
Q

conjuctiva

A

protective membrane covering all anterior globe

214
Q

ptosis

A

lid partially or fully closed

215
Q

nystagmus

A

involuntary rapid, rhythmic movement of eye in any direction

216
Q

strabismus

A

misalignment of eyes relative to eachother

217
Q

bones of ear

A

malleus incus stapes

can see malleus**
kind of incus

218
Q

nonmobile tympanic membrane

A

fluid, mass, sclerosis

219
Q

hypermobile tympanic membrane

A

ossicle bone disruption

220
Q

weber test

A

lateralization of sound

221
Q

rinne test

A

air vs. bone conductance

222
Q

PORT score

A

pneumonia severity index
-over 50 - yes
-neoplastic, CHF, cerebrovascular, renal disease, liver disease -yes
mental status, pulse >125, RR > 30, systolic < 90, temp 40 - yes

no? risk class rank

223
Q

risk class ranks?

A 
1 - based on algorithm
2 - less than 70
3 - 71-90
4 - 91-130
5 - greater than 130
224
Q

PPV

A

pneumococcal polysaccharide vaccination

225
Q

streptococcus pneumoniae

A

gram positive diplococcus

226
Q

antibiotics to use?

A

cefotaxime
ceftriaxone
respiratory fluoroquinolone

MSS PCM Exam 2 (4 decks)

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